Fibromyalgia medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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People who suffer from fibromyalgia have constant pain, fatigue, and reduced quality of life. Fibromyalgia affects about 4 million adults in the US or about 2% of the adult population. Women are twice as likely as men to have it. Although the cause of fibromyalgia is not known, it can be effectively treated and managed.

What is fibromyalgia?

Fibromyalgia syndrome is a chronic condition that causes aches and pains all over the body. This widespread pain is accompanied by fatigue, trouble sleeping, memory, and mood issues. The cause of fibromyalgia is still unknown, but it is thought that genetics plays a part.

There are several other conditions and risk factors that make you more likely to have fibromyalgia such as:

• Rheumatic diseases such as lupus or rheumatoid arthritis
• Traumatic events such as a car accident or post-traumatic stress disorder
• Depression or anxiety
• Irritable bowel syndrome (IBS)
• Ankylosing spondylitis
• Chronic fatigue syndrome
• Migraines
• Restless legs syndrome
• Illness
• Obesity

How is fibromyalgia diagnosed?

Although the exact cause of fibromyalgia is not fully understood, researchers think that the brain is misinterpreting pain signals, which results in an abnormal increase in levels of certain chemicals in the brain that signal pain. You will have a heightened pain sensitivity, feeling pain when others do not.

There is not a definitive test for the diagnosis of fibromyalgia. The symptoms of fibromyalgia, which include pain and tiredness, are shared with many other conditions so your doctor will generally try to rule them out as being the cause.

The diagnosis of fibromyalgia is based on your symptoms and physical exam. Blood tests are routinely used to exclude other causes of pain and fatigue such as anemia or thyroid disease. X-rays can be used to rule out joint pain due to osteoarthritis or other causes. Your doctor will also look at your family and medical history.

To get a diagnosis of fibromyalgia, you must have had widespread pain for at least 3 months, along with other common symptoms like fatigue, sleep disturbances, depression, concentration, and memory problems.

Although you will probably also have a physical exam that demonstrates multiple sites of pain or tender points without swelling that is not due to injury, newer guidelines from the American College of Rheumatology don’t require this for diagnosis.

What are some fibromyalgia treatment options?

If you are diagnosed with fibromyalgia, your treatment will be based on how severe your symptoms are. Treatments usually include:

• Medications. Over-the-counter and prescription pain medications and antidepressants can be used to relieve chronic pain.
• Lifestyle changes. Getting regular sleep, regular exercise, managing stress, and eating healthy can all help with fibromyalgia symptoms.
• Therapy. This can include physical therapy to help improve your strength and stamina as well as cognitive-behavioral therapy (CBT) or mindfulness-based therapy (MBT) which can help with pain management, managing stress, and improving your sleep patterns.
• Complementary therapies. These include acupuncture and massage therapy and have helped some patients with musculoskeletal pain.

What are some common fibromyalgia medications?

Medications used in the treatment of fibromyalgia help with pain relief as well as improve your mood and sleep patterns. These can include:

• Pain medications. OTC pain meds such as Motrin (ibuprofen), Aleve (naproxen sodium), and Tylenol (acetaminophen) can be useful in mild cases. Opioids are not recommended due to the lack of long-term effectiveness and possible dependency. Tramadol (Ultram) may be used to treat fibromyalgia pain if short-term use of an opioid narcotic is needed.
• Antidepressants. Cymbalta (duloxetine) and Sevilla (milnacipran) are commonly used to help with fibromyalgia pain and sleep problems, as well as improve your mood. Some older tricyclic antidepressants such as Elavil (amitriptyline) are also used in low doses.
• Anticonvulsants. Meds such as Lyrica (pregabalin) and Neurontin (gabapentin) work to reduce nerve pain.
• Muscle relaxers. Flexeril (cyclobenzaprine) is used and may help you to sleep better and have less muscle pain.

What is the best medication for fibromyalgia?

The best medication for the management of fibromyalgia will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with fibromyalgia medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare professional about the best medication for you. The table below includes a list of the most prescribed or over-the-counter fibromyalgia medications approved by the Food and Drug Administration (FDA).

Best medications for fibromyalgia

Your healthcare provider will determine the dosage which is right for you based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist and this is not a complete list.

What are the most common side effects of fibromyalgia medications?

Your reaction to these fibromyalgia medications will differ from other people’s but some common side effects seen are:

• Drowsiness
• Dizziness
• Fatigue
• Confusion
• Dry mouth
• Constipation
• Nausea
• Headache

If you experience more serious side effects such as suicidal thoughts or severe mood changes, you should seek medical attention immediately.

What are some home remedies for fibromyalgia?

Self-care is a major part of any successful fibromyalgia treatment. Some of the best ways to improve your fibromyalgia symptoms include:

• Regular exercise. Research has shown that regular exercise helps with reducing pain, depression, and insomnia. It doesn’t have to be strength or aerobic exercise. Yoga and tai chi are moderate, low-impact activities that can help build strength and stamina.
• Managing stress. Your mental health also plays a big part in managing your fibromyalgia. Reducing stress has been shown to significantly improve symptoms of fibromyalgia.
• Setting a good sleep pattern. Fatigue is one of the biggest complaints of fibromyalgia patients, so getting good quality sleep is key. You should try and go to sleep and wake up at the same times each day while also limiting daytime napping.
• Maintain a healthy lifestyle. You should try and eat a healthy diet while avoiding tobacco, alcohol, and caffeine.

Frequently asked questions about fibromyalgia

What causes fibromyalgia?

While we don’t know the exact cause of fibromyalgia, it is believed that it can be triggered by traumatic events. Fibromyalgia symptoms have started after traumatic injuries as well as following surgery, infections, and illnesses.

Mental illness, genetics, and emotional and physical trauma are also thought to be linked to the onset of fibromyalgia.

What are the most severe fibromyalgia symptoms?

Some of the most severe symptoms seen in fibromyalgia are pain, fatigue, insomnia, depression, and headaches. You can also have memory and concentration problems, which is sometimes called “fibro fog”.

Does fibromyalgia get better over time?

While it is a chronic (long-term) condition, it is not fatal and it doesn’t seem to cause damage to your muscles, joints, or organs. While everyone is different, some people do see improvements over time.

Is fibromyalgia a women’s disease?

While women are affected twice as much as men and symptoms tend to start in middle-aged adults, it can affect men and children at any age.

Related resources for fibromyalgia

• What is Fibromyalgia? Centers for Disease Control and Prevention
• Overview of Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases
• Fibromyalgia Symptoms and Causes. Cleveland Clinic
• What is Fibromyalgia? WebMD
• Fibromyalgia overview. MedlinePlus